A Mind For Mankind

Medical Pioneer Blazes Lifesaving Trails

When Dr. Ernst Trier Morch was honored by the University of Illinois at Chicago recently, medical students who met the physician/inventor/adventurer probably walked away amazed.

Morch, who emigrated from Denmark 35 years ago, is what his friends fondly call something of a character. No melancholy Dane, he is short, tanned and extremely fit at 77; he bristles with energy, wit and high spirits. He is one of those scientists with a maverick mind who gleefully flits about, fixing, figuring out things. He has made an impact in genetics, in mechanics and in medicine and as a devilishly clever saboteur against the Nazis.

Along the way, he consistently has saved lives. All doctors do that, but as the university noted in its tribute to this distinguished former faculty member at graduation ceremonies for medical residents, Ernst Morch has helped save millions of lives.

To fellow anesthesiologists, Morch is a pioneer who helped revolutionize the operating theater.

``I was drawn to anesthesia because it is the most dangerous field in medicine, therefore the most important,`` he says with customary bravado and a grin. ``You can find good surgeons all over the world. But it doesn`t help the surgeon if the patient dies from anesthesia.

``When I was starting out, we weren`t even a specialty. Anesthesia was administered by the intern or nurse who had not hidden fast enough. Oxygen and artificial airways were not used. They never started an intravenous line. Blood pressure was taken before and after surgery, but not during. We had no electrocardiograph machines. The mortality rate was incredible.

``It`s hard today to realize that not long ago we used chloroform or ether and bagged (gave anesthesia to) patients by hand, breathing for them for hours. We never operated on old people, and in those dark days

old people were defined as those over 50.``

Anesthesiologists usually seek as little drama as possible in their work

(their liability insurance is one of the highest), but for 25 years Morch was an outspoken voice in Chicago medical circles. He directed anesthesia departments at the University of Chicago and Cook County Hospitals and practiced and taught at Mt. Sinai, Garfield Park, Presbyterian-St. Luke`s and the U. of I. before leaving the city in 1980.

His great invention was what colleagues call the first practical volume respirator, based on a makeshift piston contraption he conjured up 40 years ago by mating a piece of old Copenhagen sewer pipe, a piston and some castoff hardware. The machine was a prototype of today`s respiratory care and anesthesia ventilators.

A later Morch respirator, invented in Chicago and designed for use over long periods, and similar machines developed thereafter, replaced the massive iron lung that tortured so many polio victims.

``A more wicked machine I`ve never seen,`` Morch declares. ``The worst thing was that you couldn`t get to the patient. You couldn`t even hold his hand. Just to take a blood pressure, you had to be an acrobat. You`d open the thing to give him a bedpan, and he couldn`t breathe. So you didn`t do it, and he`d get bedsores. As the machine kept him alive through negative pressure, it would suck air into his intestines. He couldn`t get rid of it; he`d bloat--the complications were horrible.``

Morch`s respirator, to which a patient was connected after a tracheotomy, was elegant in its simplicity. Among those who used it was Dr. Alon P. Winnie, Morch`s close friend and former intern, now chairman of anesthesiology at the University of Illinois, and himself a polio victim, paralyzed from the waist down. The day Winnie took ill, Oct. 26, 1959, Morch quickly performed the surgery and connected him to a Morch Piston Respirator.

The ventilator also totally changed the treatment of crushing injuries to the chest.

``The problem was over what to do with broken rib fragments,`` Morch says. ``In the old days we tried to pull them back up with sandbags, clamps, wires and contraptions. It was gruesome treatment and about 80 percent of our patients died a painful death.

``I decided to use the lungs as splints. By blowing air into them, they merely pushed the ribs back to where they belonged. Then you just kept breathing for the patient for a few weeks until the ribs were healed.``

Morch never made much money from his inventions, he says. He was proud of them and, in characteristic Morch fashion, showed them off. ``He showed them off too much and got beat to the market,`` drily notes Dr. Geraldine Light, a friend and former colleague.

Morch`s career began when he was 5 years old and decided to be a doctor, he says. He had trouble deciding what kind to be, and upon his graduation from the University of Copenhagen in 1935, he accepted residencies in psychiatry, obstetrics and pathology, but subsequently concentrated on genetics.